Effectiveness of different therapeutic strategies in preventing diverticulitis recurrence

A. Tursi, W. Elisei, G.M. Giorgetti, C.D. Inchingolo, R. Nenna, M. Picchio, M. Maiorano, A. Penna, P.G. Lecca, G. Brandimarte

Gastroenterology Service, ASL BAT, Andria, Barletta, Italy. antotursi@tiscali.it

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• Gastroenterology

BACKGROUND: Colonic diverticulitis shows a high recurrence rate.

AIMS: To assess the efficacy of three different therapeutic strategies in preventing diverticulitis recurrence.

MATERIALS AND METHODS: One hundred thirty patients suffering from Acute Uncomplicated Diverticulitis (AUD) (81 males, 49 females, mean age 64.71 years, range 40-85) were prospectively assessed. After obtaining remission, considered present when both endoscopic and histological damage were absent, the patients were treated with mesalazine 1.6 g/day (59 patients, group A), or rifaximin 800 mg/day for 7 days every month (52 patients, group B). Clinical, endoscopic and histological follow-up was performed after 6, 12 and thereafter every 12 months after diagnosis of AUD.

RESULTS: Seven patients were excluded from final evaluation because they were lost to follow-up. Fifty-five group A patients and 49 group B patients patients were available for the final assessment at the end of a 24-month follow-up. Sustained remission was significantly higher in group A with respect to group B.

CONCLUSIONS: Patients taking mesalazine have lower risk of diverticulitis recurrence than patients taking rifaximin because of the lower prevalence of persisting endoscopic and histological inflammation.

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